On-Pump versus Off-Pump Complete Arterial Revascularization Using Bilateral Internal Mammary Arteries and the T-Graft Technique: Clinical and Angiographic Results for 3,445 Patients in 13 Years of Follow-Up

Rieß, Friedrich-Christian; Heller, Stefan; Cramer, Eva B.; Awwad, N; Amin, Wagma; Hansen, Lorenz; Lehmann, Claas; Schofer, Joachim; Stripling, Jan; Winkel, S.; Kremer, P.

doi:10.1159/000448428

Cited by 9 publications

(5 citation statements)

References 24 publications

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“…In recent years, the call of CABG of multiple arterial bypass and whole arterial bypass has become higher and higher, and a large number of studies have confirmed that they have better mid-and long-term patency rates compared with veins [10,11]. This study shows that the selection of bypass material for the right coronary system has a large proportion of the great saphenous vein (92.3%), which may be related to its recent safety, relatively simple acquisition, relatively sufficient material, more plasticity and other factors.…”

Section: Discussionmentioning

confidence: 99%

Perioperative observation and study of blood flow of different bypass form in right coronary artery bypass grafting

Zhao¹,

Fu²,

Zhang³

et al. 2020

Preprint

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Background: With the aging of China's population, the incidence and mortality of coronary atherosclerotic heart disease (CAD) are increasing year by year, which brings a heavy burden to the family and society [1]. To analyse the strategy of Coronary artery bypass grafting(CABG) in right coronary artery. To compare hemodynamic characteristics of the sequential grafts with those of single grafts and observe the patency rate of those grafts for one week after-operation.Methods: A total of 242 patients (178 male, mean age 62.6±8.8 years ) underment the right coronary artery bypass grafting in our hospital from October 2016 to January 2019 were collected. The blood flow (Q, ml/min) and pulsatility index (PI) and related parameters of grafts are measured and recorded by TTFM in CABG.The patency of grafts were evaluated by coronary computed tomography(CT) for one week after operation.Results: The most common material of graft in right coronary system of CABG is great saphenous vein(92.3%), followed by the radial artery and internal mammary artery. The highest frequency target of right coronary artery is posterior descending artery (PDA)(47.6%),followed by the Right main coronary artery (RCA )(29.1%) and Posterior branch of left ventricle (PL)(23.3%).The proportion of single graft is the largest in right coronary artery in CABG(178 cases，67.9%),followed by the proportion of the graft of PDA-PL (42cases，16.0%) and other sequential grafts among the different coronary artery system (including the system of Left anterior descending artery (LAD) and Left Circumflex (LCX)).The research shows that whether the sequential grafts of PDA-PL or with other sequential grafts among the different system of coronary artery the instantaneous flow of group of sequential grafts is higher than that of single graft, and the difference has statistical significance (P < 0.01) .But there was no statistical difference of the flow between groups of sequential grafts (P = 0.410).Diastolic flow (DF) in the group of sequential grafts of right coronary system is better than that in non-sequential group (P < 0.001), and the difference has statistical significance. There was no statistical difference between the DF of groups of other system of sequential grafts and that of right coronary sequential grafts .Coronary artery CT suggests that there was 11 cases existing poor development grafts or stenosis and occlusion in week after operation,and those phenomenon mainly occurred in the group of a single graft.There was only one case which be occluded in the group of other systems of sequential grafts, and statistically significant difference existed between two groups (P < 0.01).Conclusions: The most common form of CABG in right coronary artery system is non-sequential vein bridge to PDA in our center. Whether the sequential grafts of PDA-PL or other sequential grafts among the different coronary artery system the instantaneous flow of group of sequential grafts is higher than that of single graft. DF in the group of sequential grafts of right coronary system is better than that in non-sequential group.

show abstract

Section: Discussionmentioning

confidence: 99%

Perioperative observation and study of blood flow of different bypass form in right coronary artery bypass grafting

Zhao¹,

Fu²,

Zhang³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…In recent years, the call of CABG of multiple arterial bypass and whole arterial bypass has become higher and higher, and a large number of studies have con rmed that they have better mid-and long-term patency rates compared with veins [10,11]. This study shows that the selection of bypass material for the right coronary system has a large proportion of the great saphenous vein (92.3%), which may be related to its recent safety, relatively simple acquisition, relatively su cient material, more plasticity and other factors.…”

Section: Discussionmentioning

confidence: 99%

Perioperative observations of different bypass modes of a right coronary system based on instantaneous blood flow during the operation

Zhao

Zhang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: With the ageing of China's population, the incidence and mortality of coronary atherosclerotic heart disease (CAD) is increasing year by year, which brings a heavy burden to the family and society [1]. We aimed to analyse the strategy of coronary artery bypass grafting (CABG) in the right coronary artery and to compare the haemodynamic characteristics of the sequential grafts with those of single grafts and to observe the patency rate of those grafts for one week after the operation.Methods: A total of 242 patients (178 men, mean age 62.6±8.8 years) underwent right coronary artery bypass grafting in our hospital from October 2016 to January 2019. The blood flow (Q, ml/min), pulsatility index (PI) and related parameters of the grafts were measured and recorded by TTFM during the CABG. The patency of the grafts was evaluated by coronary computed tomography (CT) for one week after the operation. Results: The most common material used for the graft in the right coronary system of CABG is the greater saphenous vein (92.3%), followed by the radial artery (5.5%) and the internal mammary artery (1.9%). The highest frequency target of the right coronary artery is the posterior descending artery (PDA) (47.6%), followed by the right main coronary artery (RCA) (29.1%) and the posterior branch of the left ventricle (PL) (23.3%). The proportion of single grafts was the highest for the right coronary artery in CABG (178 cases, 67.9%), followed by a graft of the PDA-PL (42 cases, 16.0%) and other sequential grafts among the different coronary artery systems (including the system of the left anterior descending artery (LAD) and the left circumflex (LCX)). Whether there were sequential grafts of the PDA-PL or other sequential grafts among the different systems of the coronary artery, the instantaneous flow of a group of sequential grafts was higher than that of a single graft, and the difference had statistical significance (P < 0.01). However, there were no significant differences in the flow between the groups of sequential grafts (P = 0.410). Diastolic flow (DF) in the group of sequential grafts of the right coronary system was better than that in the non-sequential group (P < 0.001), and the difference had statistical significance. There was no significant difference between the DF of the groups of the other system of sequential grafts and that of the right coronary sequential grafts. Coronary artery CT suggested that there were 11 cases of poorly developing grafts or stenosis and occlusion a week after the operation, and those phenomenon mainly occurred in the group with a single graft. There was only one case that was occluded in the group of other systems of sequential grafts, and statistically significant differences existed between the two groups (P < 0.01).Conclusions: In our centre, the most common form of CABG in the right coronary artery system is a non-sequential vein bridge to the PDA. Whether there are sequential grafts of the PDA-PL or other sequential grafts among the different coronary artery systems, the instantaneous flow of a group of sequential grafts is higher than that of a single graft. DF in the group of sequential grafts of the right coronary system was better than that in the non-sequential group.

show abstract

“…In recent years, the use of CABG for multiple arterial bypass and whole arterial bypass has become increasingly common, and a large number of studies have confirmed that these patients better mid-and long-term patency rates compared with veins [10,11]. This study showed that the bypass material for the right coronary system is generally the greater saphenous vein (92.3%), which may be related to its relative safety, relatively simple acquisition, relatively sufficient material, more plasticity, and other factors.…”

Section: Discussionmentioning

confidence: 99%

Perioperative observations of different bypass modes of a right coronary system based on instantaneous blood flow during the operation

Zhao

Zhang

et al. 2020

J Cardiothorac Surg

View full text Add to dashboard Cite

show abstract

On-Pump versus Off-Pump Complete Arterial Revascularization Using Bilateral Internal Mammary Arteries and the T-Graft Technique: Clinical and Angiographic Results for 3,445 Patients in 13 Years of Follow-Up

Cited by 9 publications

References 24 publications

Perioperative observation and study of blood flow of different bypass form in right coronary artery bypass grafting

Perioperative observation and study of blood flow of different bypass form in right coronary artery bypass grafting

Perioperative observations of different bypass modes of a right coronary system based on instantaneous blood flow during the operation

Perioperative observations of different bypass modes of a right coronary system based on instantaneous blood flow during the operation

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